- Deficit Reduction Act Webpage: The DRA provides states with much of the flexibility states have been seeking over the years to make significant reforms to their Medicaid programs.
- Targeted Case Management Rule: CMS' interim final rule with comment period implementing section 6052 of the DRA clarifies the Medicaid definition of covered case management and targeted case management (TCM) services. For additional information, see the fact sheet and regulation.
- Tamper Resistant Prescription Pads: CMS released guidance through a State Medicaid Director Letter providing baseline requirements to States to define and implement tamper-resistant prescription pads as required by law. The documents "Medicaid Tamper Resistant Prescription Information for State Policymakers" and "Top Questions on Tamper Resistant Prescriptions" provide additional background information.
- Update: On Saturday, September 29, 2007, President Bush signed the "Extenders Law," delaying the implementation date for all paper Medicaid prescriptions to be written on tamper-resistant paper. Under the new law, as of April 1, 2008, all written Medicaid prescriptions must be on tamper-resistant prescription pads.
- CMS' guidance on the tamper-resistant law, set forth in an August 17, 2007 State Medicaid Director letter, contains two phases. For the first, a prescription must contain at least one of the three tamper-resistant characteristics in order to be considered "tamper resistant." For the second, prescriptions must contain all three characteristics.
- The two-phased approach is still in effect. At least one of the three tamper-resistant characteristics is required on April 1, 2008. All three characteristics are required on October 1, 2008.
- Reasonable Crowd Out Procedures in SCHIP: CMS released a State Medicaid Directors letter that clarifies the application of existing statutory and regulatory requirement in State requests to extend eligibility under the SCHIP program to children in families with effective family income levels above 250 percent of the Federal poverty level (FPL).
- Proof of Citizenship: Section 6030 of the Deficit Reduction Act of 2005 requires individuals to provide satisfactory documentary evidence of citizenship or nationality when initially applying for Medicaid or upon a recipient's first Medicaid re-determination. The page gives copies of the law, guidance from CMS, printable posters & brochures for use in outreach & education, and a PowerPoint presentation on the new requirements.
Part D Spotlight
Act Now to Meet Prescription Drug Coverage Needs for 2008: CMS continues to encourage all Medicare beneficiaries to review their current health care coverage and ensure they are in a plan that will best meet their needs in 2008. Beneficiaries who wish to enroll for the first time or change their coverage for 2008 should do so as soon as possible to ensure a smooth transition in the New Year. The annual open enrollment period began on November 15th and runs through December 31st, 2007. Additional information can be found in the press release.
2008 Part D Premiums and Additional Information Announced: Due in large part to strong competitive bidding by health and prescription drug plans and beneficiaries' choices, CMS anticipates that the actual average premium paid by beneficiaries for standard Part D coverage in 2008 will be roughly $25. A press release, a fact sheet and additional information on 2008 national average monthly bid; the base beneficiary premium; the regional low-income subsidy premium amounts for 2008; and the 2008 Medicare Advantage regional PPO benchmarks can be found on the CMS website.
2008 Plan Choices: State level information about Part D plan options in 2008 is now available. The press release can be found online. We have posted a reference list of the 2008 plan options on the web containing a preview of the plan names and limited cost information while we continue to load data into the plan finder tools, including the data list and instructions along with helpful information about open enrollment.
Information on Re-determining Eligibility for People Who Qualify for Low-Income Subsidy Automatically: Beginning this August, CMS will determine if individuals who automatically qualified (were deemed eligible) for LIS in calendar year 2007 will automatically qualify for LIS in 2008. The background document "Re-determining Eligibility for People Who Qualify for the Low-Income Subsidy Automatically" provides more information on the redetermination process.
2007 Low Income Subsidy Toolkit: This toolkit provides important resources for partners to help beneficiaries learn about and apply for extra help, including general targeting estimates to help assist in on-going outreach activities..
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